cASE: “i cAN’T Do iT All!” bAckgRouND AND cASE ovERviEWBased in Walnut Creek, California, Healthdyne is a health maintenance organization (HMO) that provides healthcare to the northern California Bay Area. It serves approxi- mately 1.2 million enrollees composed mainly of upper-class, white-collar professionals. Healthdyne occupies a relatively small corner of the market, but is quickly gaining promi- nence in the area and has developed a solid financial footing with bright prospects. It is located in a growing community, with a 15 to 20 percent annual growth rate projected for the next five years.For the past 20 years, Healthdyne’s former president, Amanda Huggins, has suc- cessfully carried out the organizational mission—to provide more affordable and better quality healthcare for its members by setting the statewide standard for excellence and responsiveness. As one of the key players in the organization since its inception, Ms. Hug- gins is a recognized expert in the managed care industry. Corporate legend has it that her motto was “It doesn’t happen without my signature!” Upon Ms. Huggins’s retirement, Arnold Brice was recruited to take her place.oRgANizATioNAl PRoblEmWhen Mr. Brice, who is the former CEO of Atlantic Healthcare, was brought in as presi- dent, he inherited an executive staff composed of the vice presidents of the marketing, finance, and professional services departments as well as a medical director, all of whom were capable of fulfilling their managerial responsibilities. However, within a few weeks of joining Healthdyne, Mr. Brice perceived a serious flaw with his staff—none of the vice presidents would make a decision, not even on routine matters such as personnel ques- tions, choice of marketing media, or changing suppliers. The vice presidents frequently presented him with issues in their areas of responsibility and requested that he make the decision. This troubled Mr. Brice. Before long, the situation seriously impeded his efforts to engage in strategic planning for the HMO.At a regular staff meeting, when every member of his staff had an issue that required his attention, Mr. Brice finally blew up. The catalyst to this incident was this question from the Finance vice president: “What font do you want this in?”Waving his arms in exasperation, Mr. Brice shouted, which is very uncharacteristic of him, “I cannot do it all! You are going to have to make these decisions yourselves.”The meeting broke up with the staff looking very puzzled and Mr. Brice realizing that he had to make serious changes.